RECRUITING

NEXUS Aortic Arch Clinical Study to Evaluate Safety and Effectiveness

Conditions

Aortic Dissection Aortic Aneurysm Intramural Hematoma Penetrating Aortic Ulcer

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Prospective, non-randomized, multi-center clinical investigation of the NEXUS™ Aortic Arch Stent Graft System (NEXUSTM) for the treatment of thoracic aortic lesions involving the aortic arch with a proximal landing zone, native or previously implanted surgical graft, in the ascending aorta and with a brachiocephalic trunk native landing zone.

Official Title

A Multi-arm, Multi-Center, Non-Randomized, Prospective, Clinical Study to Evaluate the Safety and Effectiveness of the NEXUS Aortic Arch Stent Graft System in Treating Thoracic Aortic Lesions Involving the Aortic Arch

Quick Facts

Study Start:2020-10-20

Study Completion:2029-10

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT04471909

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
1. Male and female age ≥ 18. 2. Proximal/ascending native or previously implanted surgical graft landing zone of appropriate length 3. Proximal/ascending native or previously implanted surgical graft landing zone of appropriate diameter 4. Distal/descending native landing zone of appropriate length 5. Distal/descending native landing zone of appropriate diameter 6. Brachiocephalic trunk native landing zone of appropriate length 7. Brachiocephalic trunk native landing zone of appropriate diameter 8. Appropriate take off angle between the Brachiocephalic Artery and the Aortic Arch perpendicular 9. Appropriate aortic arch perpendicular diameter 10. Chronic dissection with at least one of the following conditions: 1. An aortic aneurysm with a maximum diameter ≥ 55 mm 2. Rapidly expanding false lumen (growth of \> 0.5 cm/6 months) 3. Compressed true lumen associated with end organ malperfusion 4. Symptomatic 11. Aneurysm with at least one of the following conditions: 1. Dilatation of the aortic arch larger than 5 cm in diameter for subject with fusiform aneurysm 2. Dilatation of the aortic arch is 1.5 times the normal diameter for subjects ascending or descending 3. Dilation of the aortic arch larger than 2.5 cm for subject with saccular aneurysm 4. Symptomatic aneurysm of the aortic arch 5. Aortic diameter growth rate \> 5mm per 6 months 6. Postoperative pseudoaneurysm expanding from anastomotic suture lines 12. Penetrating aortic ulcer with at least one of the following: 1. Symptomatic 2. Ulcer demonstrates expansion 13. Intramural hematoma with at least one of the following: 1. Symptomatic (persistent pain) 2. Transverse or longitudinal expansion on serial imaging 14. In the event of a lesion in the ascending aortic, the proximal/ascending native or previously implanted surgical graft the landing zone must be appropriate 15. Femoral / iliac artery diameter as documented by CTA or MRA that allows endovascular access to the diseased site with a 20 Fr. delivery catheter. 16. Access vessels morphology suitable for endovascular repair in terms of tortuosity, calcification and angulation, documented by CTA/MRA. 17. Brachial/Axial Artery diameter that allows endovascular access suitable for 7 Fr. 18. Subject is considered an appropriate candidate for an elective surgery. 19. Subject is considered to be at high risk for open repair, as determined by the investigator. 20. Access vessels, iliac/femoral \& brachial/axillary compatible with vascular access techniques (femoral cutdown or percutaneous), devices, and /or accessories. 21. Subject is willing and able to comply with procedures specified in the protocol and is able to return for follow-up visits as specified by the protocol.	1. Acute dissection 2. Lesions that can be safely treated with TEVAR landing in zone 2 (with or w/o LSA vascularization) 3. Required emergent treatment, e.g., trauma, rupture 4. Acute vascular injury of the aorta due to trauma 5. Aortic rupture or unstable aneurysm 6. Received a previous stent or stent graft in the treated area (including planned landing area) 7. Required surgical or endovascular treatment of an infra-renal aneurysm at time of implantation 8. Planned major surgical or interventional procedure at time of screening, to be performed after the NEXUS™ implantation. 9. Any major surgical or interventional procedure 6 weeks before the NEXUS™ implantation, exclusive of planned procedures that are needed for the safe and effective placement of the stent graft (e.g. supra-aortic bypass). 10. Subject has had a myocardial infarction (MI) or cerebral vascular accident (CVA) within 90 days prior to the planned implantation 11. Subjects with severe aortic valvular insufficiency as determined by echocardiography 12. Mechanical valve that preclude safe delivery of NEXUS™ 13. Known Connective tissue disease (e.g., Marfan's or Ehler's-Danlos syndromes) 14. Subject has an active systemic infection at the time of the procedure documented by pain, fever, drainage, positive culture 15. Pregnant 16. Life expectancy of less than 2 years 17. Unsuitable vascular anatomy 18. Subject who have a previously implanted surgical wrap of the ascending aorta 19. Any medical condition that, according to the investigator's decision, might expose the subject to increased risk by the investigational device or procedure. 20. An aneurysm that is mycotic, inflammatory or suspected to be infected. 21. Subject with hostile groins/axilla (scarring, obesity, or previous failed puncture) unless conduit are used. 22. Subjects with severe atherosclerosis, severe calcification or extensive intraluminal thrombus of the aorta or in the brachiocephalic trunk 23. Subject is suffering from unstable angina or NYHA classification III and IV. 24. Subject has a known hypersensitivity or contraindication to anticoagulants, antiplatelets, or contrast media, which is not amenable to pre-treatment. 25. Subject with a contraindication to undergo angiography 26. Subject with known sensitivities or allergies to the device materials (including Nitinol \[NiTi\], polyester fabric \[PET\], tantalum \[TA\]) 27. Clinical conditions that severely inhibit x-ray visualization of the Aorta. 28. Subject has history of bleeding diathesis or coagulopathy that may limit the use of dual antiplatelet or anticoagulant therapy by the decision of the investigator 29. Acute renal failure; chronic renal failure (excluding dialysis); Creatinine \> 2.00 mg/dl 30. Any other medical, social, or psychological issues that in the opinion of the investigator preclude them from receiving this treatment, or the procedures and evaluations pre- and post- treatment. 31. Active participation in another clinical study that has not completed primary endpoint(s) evaluation or that clinically interferes with the endpoints in this study, or subject is planning to participate in such study prior to the completion of this study.

Inclusion Criteria

Exclusion Criteria

1. Male and female age ≥ 18.
2. Proximal/ascending native or previously implanted surgical graft landing zone of appropriate length
3. Proximal/ascending native or previously implanted surgical graft landing zone of appropriate diameter
4. Distal/descending native landing zone of appropriate length
5. Distal/descending native landing zone of appropriate diameter
6. Brachiocephalic trunk native landing zone of appropriate length
7. Brachiocephalic trunk native landing zone of appropriate diameter
8. Appropriate take off angle between the Brachiocephalic Artery and the Aortic Arch perpendicular
9. Appropriate aortic arch perpendicular diameter
10. Chronic dissection with at least one of the following conditions:
1. An aortic aneurysm with a maximum diameter ≥ 55 mm
2. Rapidly expanding false lumen (growth of \> 0.5 cm/6 months)
3. Compressed true lumen associated with end organ malperfusion
4. Symptomatic
11. Aneurysm with at least one of the following conditions:
1. Dilatation of the aortic arch larger than 5 cm in diameter for subject with fusiform aneurysm
2. Dilatation of the aortic arch is 1.5 times the normal diameter for subjects ascending or descending
3. Dilation of the aortic arch larger than 2.5 cm for subject with saccular aneurysm
4. Symptomatic aneurysm of the aortic arch
5. Aortic diameter growth rate \> 5mm per 6 months
6. Postoperative pseudoaneurysm expanding from anastomotic suture lines
12. Penetrating aortic ulcer with at least one of the following:
1. Symptomatic
2. Ulcer demonstrates expansion
13. Intramural hematoma with at least one of the following:
1. Symptomatic (persistent pain)
2. Transverse or longitudinal expansion on serial imaging
14. In the event of a lesion in the ascending aortic, the proximal/ascending native or previously implanted surgical graft the landing zone must be appropriate
15. Femoral / iliac artery diameter as documented by CTA or MRA that allows endovascular access to the diseased site with a 20 Fr. delivery catheter.
16. Access vessels morphology suitable for endovascular repair in terms of tortuosity, calcification and angulation, documented by CTA/MRA.
17. Brachial/Axial Artery diameter that allows endovascular access suitable for 7 Fr.
18. Subject is considered an appropriate candidate for an elective surgery.
19. Subject is considered to be at high risk for open repair, as determined by the investigator.
20. Access vessels, iliac/femoral \& brachial/axillary compatible with vascular access techniques (femoral cutdown or percutaneous), devices, and /or accessories.
21. Subject is willing and able to comply with procedures specified in the protocol and is able to return for follow-up visits as specified by the protocol.

1. Acute dissection
2. Lesions that can be safely treated with TEVAR landing in zone 2 (with or w/o LSA vascularization)
3. Required emergent treatment, e.g., trauma, rupture
4. Acute vascular injury of the aorta due to trauma
5. Aortic rupture or unstable aneurysm
6. Received a previous stent or stent graft in the treated area (including planned landing area)
7. Required surgical or endovascular treatment of an infra-renal aneurysm at time of implantation
8. Planned major surgical or interventional procedure at time of screening, to be performed after the NEXUS™ implantation.
9. Any major surgical or interventional procedure 6 weeks before the NEXUS™ implantation, exclusive of planned procedures that are needed for the safe and effective placement of the stent graft (e.g. supra-aortic bypass).
10. Subject has had a myocardial infarction (MI) or cerebral vascular accident (CVA) within 90 days prior to the planned implantation
11. Subjects with severe aortic valvular insufficiency as determined by echocardiography
12. Mechanical valve that preclude safe delivery of NEXUS™
13. Known Connective tissue disease (e.g., Marfan's or Ehler's-Danlos syndromes)
14. Subject has an active systemic infection at the time of the procedure documented by pain, fever, drainage, positive culture
15. Pregnant
16. Life expectancy of less than 2 years
17. Unsuitable vascular anatomy
18. Subject who have a previously implanted surgical wrap of the ascending aorta
19. Any medical condition that, according to the investigator's decision, might expose the subject to increased risk by the investigational device or procedure.
20. An aneurysm that is mycotic, inflammatory or suspected to be infected.
21. Subject with hostile groins/axilla (scarring, obesity, or previous failed puncture) unless conduit are used.
22. Subjects with severe atherosclerosis, severe calcification or extensive intraluminal thrombus of the aorta or in the brachiocephalic trunk
23. Subject is suffering from unstable angina or NYHA classification III and IV.
24. Subject has a known hypersensitivity or contraindication to anticoagulants, antiplatelets, or contrast media, which is not amenable to pre-treatment.
25. Subject with a contraindication to undergo angiography
26. Subject with known sensitivities or allergies to the device materials (including Nitinol \[NiTi\], polyester fabric \[PET\], tantalum \[TA\])
27. Clinical conditions that severely inhibit x-ray visualization of the Aorta.
28. Subject has history of bleeding diathesis or coagulopathy that may limit the use of dual antiplatelet or anticoagulant therapy by the decision of the investigator
29. Acute renal failure; chronic renal failure (excluding dialysis); Creatinine \> 2.00 mg/dl
30. Any other medical, social, or psychological issues that in the opinion of the investigator preclude them from receiving this treatment, or the procedures and evaluations pre- and post- treatment.
31. Active participation in another clinical study that has not completed primary endpoint(s) evaluation or that clinically interferes with the endpoints in this study, or subject is planning to participate in such study prior to the completion of this study.

Contacts and Locations

Study Contact

Jessica Kleine

CONTACT

+1 (612) 280-0208

j.kleine@endospan.com

Carrie MacNabb

CONTACT

c.macnabb@endospan.com

Study Locations (Sites)

University of Alabama Birmingham

Birmingham, Alabama, 35294

United States

University of California San Diego Medical Center

La Jolla, California, 92037

United States

Stanford University School of Medicine

Stanford, California, 94305

United States

University of Colorado

Aurora, Colorado, 80045

United States

Hartford Healthcare

Hartford, Connecticut, 06102

United States

Advent Health Orlando

Orlando, Florida, 32804

United States

Emory University

Atlanta, Georgia, 30322

United States

The University of Chicago

Chicago, Illinois, 60637

United States

Ascension St. Vincent

Carmel, Indiana, 46290

United States

University of Maryland

Baltimore, Maryland, 21201

United States

Tufts Medical Center

Boston, Massachusetts, 02111

United States

University of Michigan

Ann Arbor, Michigan, 48109

United States

Washington University School of Medicine

Saint Louis, Missouri, 63110

United States

The Mount Sinai Medical Center

New York, New York, 10029

United States

Northwell Health Lenox Hill Hospital

New York, New York, 10075

United States

University of North Carolina

Chapel Hill, North Carolina, 27599

United States

Atrium Health

Charlotte, North Carolina, 28203

United States

Duke University Medical Center

Durham, North Carolina, 27710

United States

The Lindner Research Center

Cincinnati, Ohio, 45219

United States

University Hospital

Cleveland, Ohio, 44106

United States

Oregon Health

Portland, Oregon, 97239

United States

University of Pennsylvania

Philadelphia, Pennsylvania, 19104

United States

Lankenau Medical Center

Wynnewood, Pennsylvania, 19096

United States

Medical University of South Carolina

Charleston, South Carolina, 29425

United States

Ballad Health

Kingsport, Tennessee, 37660

United States

Vanderbilt University Medical Center

Nashville, Tennessee, 37232

United States

Baylor Scott and White

Plano, Texas, 75093

United States

Sentara Norfolk General Hospital

Norfolk, Virginia, 23507

United States

Carilion Clinic

Roanoke, Virginia, 24014

United States

MedStar Washington Hospital

Northwest, Washington, 20010

United States

Collaborators and Investigators

Sponsor: Endospan Ltd.

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2020-10-20

Study Completion Date2029-10

Study Record Updates

Study Start Date2020-10-20

Study Completion Date2029-10

Terms related to this study

Additional Relevant MeSH Terms

Aortic Dissection
Aortic Aneurysm
Intramural Hematoma
Penetrating Aortic Ulcer